摘要：Objectives. To use data on the governmental public health workforce to examine demographics and elucidate drivers of job satisfaction and intent to leave one’s organization. Methods. Using microdata from the 2014 Federal Employee Viewpoint Survey and 2014 Public Health Workforce Interests and Needs Survey, we drew comparisons between federal, state, and local public health staff. We fitted logistic regressions to examine correlates of both job satisfaction and intent to leave one’s organization within the coming year. Results. Correlates of job satisfaction included pay satisfaction, organizational support, and employee involvement. Approximately 40% of federal, state, and local staff said they were either considering leaving their organization in the next year or were planning to retire by 2020. Conclusions. Public health practitioners largely like their jobs, but many are dissatisfied with their pay and are considering working elsewhere. More should be done to understand the determinants of job satisfaction and how to successfully retain high-quality staff. Public Health Implications. Public health is at a crossroads. Significant turnover is expected in the coming years. Retention efforts should engage staff across all levels of public health. The mission of public health is to prevent disease, promote health, and prolong life for the United States population through the core functions of public health (assessment, policy development, and assurance). 1–4 To fulfill this mission, there are approximately 300 000 public health employees at the federal, state, and local levels. 5 The governmental public health workforce comprises federal (20%), state (30%), and local health department employees (50%). 5 Each of these groups makes essential contributions to the public health enterprise. A recent study found that 38% of state health agency (SHA) employees intend to leave governmental public health before 2020. 6 However, the number of local and federal public health employees planning to leave is not well studied, 6 although the consequences of employee turnover are well documented. High levels of employee turnover lead to a loss of expertise and institutional knowledge, high costs to the organization, and a decrease in organizational performance. 7–9 Retaining institutional knowledge through employees is especially important in the public sector, which undergoes high levels of change. 10 Additionally, the cost to recruit and train new employees can amount to 50% to 200% of the employee’s annual salary. 11 Furthermore, organizational and individual performance suffers because workers who intend to leave are less efficient and effective in their job roles. 12 Studies show that a variety of factors contribute to turnover and can be categorized into external, work-related, and personal factors. 7,12,13 Two external factors related to intent to leave are perception of job alternatives, which is positively related to turnover, and the presence of a union, which is negatively related to turnover. 7,9,12–16 Pay satisfaction was consistently identified as an important factor in intent to leave; 29 of 32 studies in a meta-analysis showed a negative association. 13 Finally, personal factors such as age, education, number of dependents, health status, and race/ethnicity have been significantly related to turnover and intent to leave. 13 Although there are many contributors to workers’ intent to leave, a review of the literature shows a consistently negative relationship between worker turnover and job satisfaction. 14,17,18 Although the field is beginning to study this area among SHA workers, 14,19 relatively little is known about local or federal level job satisfaction or intent to leave. We address that gap.
